14 Most Common Causes of Hip Pain in Athletes

Hip pain is a relatively common problem in athletes. The most common culprits of hip discomfort in athletes include overuse syndromes or direct impact injuries, but conditions such as arthritis, bursitis, muscle strain, and nerve irritation can also be to blame.

It's important for an athlete to pay attention to hip pain when it begins in order to prevent a chronic condition from developing. Here are some of the more common causes of hip pain in athletes.

Muscle Pulls or Strains

Photo of a woman running with hip pain.

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Pain in the front of the hip and inner thigh (groin) is often the result of an adductor muscle pull or strain. Though similar to other muscle strains, this acute muscle injury occurs when the muscles of the front and inner thigh (​the adductors) are stressed beyond their limits. It's common in sprinters, soccer players, football players, and weightlifters.​

Hip Labral Tear

Hip labral tears occur when the labrum, a band of cartilage surrounding the hip joint, is injured. These injuries are often the result of stress to the hip joint caused by falling or repetitive twisting motions. Symptoms include groin pain, a clicking or snapping feeling in the hip, and limited mobility.

Treatment usually involves anti-inflammatory medications and physical therapy. It may also be treated with arthroscopy.

Hip Pointer

Hip pointers are caused by a sudden impact that's hard enough to bruise your iliac crest (hipbone), greater trochanter (the top of your leg bone), or the surrounding soft tissue. The affected area is usually bruised, and the pain can be intense. Proper protective equipment can help prevent hip pointers, and immediate first aid can speed recovery.

Hip Bursitis

The hip bursa is a fluid-filled sac that reduces the friction between your tendons, muscles, and bones, reducing friction. Hip bursitis, also called trochanteric bursitis, occurs when the bursa becomes inflamed and causes pain during almost all hip movement. Hip bursitis commonly affects runners and those who play high contact sports.

Hip Osteoarthritis

Hip osteoarthritis is one of the most common causes of chronic hip pain for both athletes and non-athletes alike. Over time, the smooth, protective cartilage of the hip socket wears down and bare bone is exposed, making movement painful. There are many treatments available, ranging from hip-strengthening exercises to hip replacement surgery.

Osteitis Pubis

Sports activities like soccer, hockey, and football can cause osteitis pubis, which is an inflammation where the major pelvic bones meet in the pubic area. This can result in pain in the front of the pelvis, usually in the middle, and can lead to weakness or limping. Rest is the most important treatment.

Iliopsoas Syndrome

Iliopsoas syndrome causes hip pain, stiffness, and snapping in the groin area. This type of pain may be related to iliopsoas bursitis (inflammation of the bursa) or iliopsoas tendonitis (inflammation of the hip flexor tendon). The condition occurs more often in gymnasts, dancers, and track and field athletes who perform repeated hip flexion movements.

Piriformis Syndrome

The piriformis muscle is a small muscle in the buttock region located near the sciatic nerve. It stabilizes the hip joint and helps it externally rotate. Piriformis syndrome occurs when this muscle spasms and compresses the sciatic nerve, causing pain in your lower body. The pain often radiates down the back of the thigh or up to the lower back.

Hip Stress Fracture

A less common injury in long-distance runners includes a stress fracture of the hip caused by repetitive micro-trauma to the bone over time. Like stress fractures in other bones, the best treatment is to avoid the impact of running and allow the bone to heal.

Tailbone Injury

Tailbone injuries are often due to a direct fall onto the coccyx (the bones that make up the very end of the spinal column). The severity of tailbone injuries can range from a bruise to a fracture. Most tailbone injuries heal on their own given time and conservative treatment.

IT Band Syndrome

Iliotibial (IT) band syndrome, also called IT band friction syndrome, is a common cause of both knee and hip pain in athletes. It causes pain along the outside of the knee joint or near the hip that increases when running up or down hills or getting up from a seated position. The IT band stabilizes your knee when you run and may become irritated from overuse.

Pulled Hamstring

A pulled hamstring happens when one or more of your hamstring muscles gets stretched too far and starts to tear. It can be mild or severe and typically causes sudden, sharp pain in the back of the thigh. This injury is common among athletes who do a lot of sprinting or jumping. Immediate rest, ice, compression, and elevation (RICE) can help speed recovery.

Sports Hernia

Sports hernia is also called athletic pubalgia. It is due to a weakening of the lower abdominal wall where the muscles and tendons are thinner and an outpouching occurs. It results in pain in the lower abdomen, groin, or testicles. It's more common in hockey, football, and soccer. If conservative treatment doesn't work, surgery may be done.

Hip Impingement

Femoroacetabular impingement (FAI) is a condition where your ball-and-socket hip joint has an abnormal shape. This leads to forming bone spurs around the hip joint, which cause pain and lead to labral tears of the hip and hip arthritis. As such, FAI contributes to other hip pain causes.

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Additional Reading

By Elizabeth Quinn, MS
Elizabeth Quinn is an exercise physiologist, sports medicine writer, and fitness consultant for corporate wellness and rehabilitation clinics.